CHILDREN’S CHAT 

Same-Sex Parenthood: Families Need Acceptance & Access to Healthcare

Almost one-fifth of the LGBT population in Tennessee is raising children. Same-sex parents, just like different-sex parents, desire to raise a healthy family and obtain services that meet their family’s needs. Many studies have confirmed that children of same-sex parents are not at a disadvantage in educational and psychological outcomes based on their family structure. Despite this evidence as well as legal and societal gains for same-sex families, the impact of stigma and discrimination still affects children in same-sex families.

Children of same-sex families are emotionally affected when they and/or their families are exposed to homophobia, discrimination, prejudice and social stigma. Communities with more accepting attitudes of LGBT people are better for children of same-sex couples. While same-sex parents cannot control the responses of others to their family structure, having adequate healthcare services to ensure the healthy emotional development of their children is important. Inclusive health insurance and healthcare professionals who are adept at navigating conversations and care around sexuality, gender, and alternative family structures are important for these families.

A barrier many LGBT people face when trying to access health care is unemployment and poverty. This barrier also holds true for same-sex parents. Households headed by same-sex couples are more likely to live in poverty than those headed by demographically similar heterosexual couples. Same-sex couples with children tend to be female, black, Latinx, and younger than different-sex couples with children. Since these groups tend to be more economically disadvantaged in the United States, free or low-cost coverage options like Medicaid and CHIP can help ensure that healthy parents lead healthy families.

Before the Affordable Care Act (ACA), barriers to accessing healthcare coverage for LGBT individuals included denial by insurers based on sexual orientation, exclusion of certain services relating to gender orientation, and higher rates based on sexual orientation or gender identity. Following enactment of the ACA, more LGBT individuals have access to healthcare. For example, the national LGBT Medicaid coverage rose from 7% to 15% between 2013 and 2016. Changes in legislation have also led to more protections for same-sex parents and their families. As a result of the Obergefell decision, state Medicaid and Children’s Health Insurance Programs must consider married same-sex couples a family when determining eligibility for these programs. The combination of the ACA and federal recognition of same-sex marriage have contributed to expanding national access and coverage to LGBT families.

Recent legal and policy changes have helped to increase access to care and insurance for LGBT individuals and their families. However, some barriers still prevent LGBT parents and families from receiving the best care. Stigma and homophobia lead to poor treatment from healthcare providers. While LGBT individuals are protected against discrimination in healthcare, there are still instances in which it occurs at the provider level. Discrimination by providers prevents LGBT patients from pursuing care, which is not good for the health of the family.

Education and training are tools that healthcare providers can use to combat this barrier to access that LGBT families face. Many organizations, like the Gay and Lesbian Medical Association, have created directories of providers who are culturally competent and adept at providing care to LGBT parents and their children. LGBT-friendly providers, while scarce in rural areas, can still be extremely difficult to find in metropolitan areas.

Below are a few resources for LGBTQ+ parents to find supportive primary, sexual, and mental health care:

• Nashville Gay Parents: The Nashville Gay Parent group builds a community that nurtures and accepts all families equally. Through social activities, public awareness and resource matching, the group weaves the fabric of our families throughout the Greater Nashville area to strengthen all families. Look here for their local LGBT family resources.
• The Human Rights Campaign’s 2018 Healthcare Equality Index surveyed 626 medical facilities in the areas of staff training in LGBTQ+ services, domestic partner benefits, and patient/employment non-discrimination. Use their interactive map to find an LGBTQ-friendly healthcare facility near you.
• Strong Families Network created a guide to assist LGBT people in evaluating healthcare needs and navigating insurance options and providers for your family. The Affordable Care Act does not have a universal definition of “family”. This can confuse families who are researching their best options. This resource is excellent in providing questions to ask your insurance company around coverage for your same-sex partner.
• PFLAG Nashville: Made up of LGBTQ individuals, family members, and allies PFLAG listens, encourages, guides, and assists you as you work to understand what it means to be LGBT. The non-profit is committed to helping families become stronger together. You can attend monthly meetings, and so can your family members and friends, where dialogue fosters better understanding and respect of LGBT people.
• GLBT National Resource Database: Enter your zip code and the distance you are willing to travel to find social and support resources, community centers, and youth groups near you.
• CoverRx: A prescription drug program designed to assist those who have no pharmacy coverage, but have a need for medication. CoverRx has no monthly premiums, just affordable co-pays.
• Behavioral Health Safety Net: If you are 19 years of age or older, have a serious mental illness, and have no behavioral health insurance, you may qualify for the Behavioral Health Safety Net of TN program. Services provided by this program include assessment, evaluation, diagnostic, therapeutic intervention, case management, transportation, peer support services, psychosocial rehabilitation services, psychiatric medication management, labs related to medication management and pharmacy assistance, and coordination.

As the Tennessee Justice Center is concerned with helping all families access resources to meet their healthcare needs, we join others in sharing these resources to support same-sex couples and their children.